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Living With Multiple Sclerosis

By Piet Mesmer

THE COMPLETE GUIDE TO TREATMENT AND

MANAGEMENT OF MULTIPLE SCLEROSIS (MS)

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“Living with Multiple Sclerosis” by Piet Mesmer

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Table of Contents

Table of Contents ................................................................................ 2

Please Read This First! ....................................................................... 6

Terms of Use ............................................................................................................ 6

Disclaimer................................................................................................................. 6

About the Author ................................................................................. 8

1. Multiple Sclerosis – An Overview .................................................. 9

Incidence .................................................................................................................. 9

2. What is Multiple Sclerosis? .......................................................... 12

3. The Immune System and Multiple Sclerosis............................... 14

Immune System ................................................................................................. 14

Relation between the Immune System and Multiple Sclerosis .................... 14

4. How Serious Is Multiple Sclerosis? ............................................. 16

The Effects at a Glance:.................................................................................... 17

5. Who Gets Multiple Sclerosis? ...................................................... 19

6. Types of Multiple Sclerosis .......................................................... 21

Other Common Terms for Multiple Sclerosis:................................................ 22

7. Signs and Symptoms of Multiple Sclerosis ................................ 24

8. Myths and Facts about Multiple Sclerosis .................................. 26

Other Facts about Multiple Sclerosis .................................................................. 27

9. Causes of Multiple Sclerosis........................................................ 28

Genetic Factors ..................................................................................................... 28

Infectious Agents .................................................................................................. 29

10. Cognitive Impairment in Multiple Sclerosis .............................. 31

What is cognitive impairment? ........................................................................ 31

Causes of Cognitive Impairment in Multiple Sclerosis ..................................... 31

Diagnosis of Cognitive Impairment ..................................................................... 31

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Is Cognitive Impairments Inevitable with Multiple Sclerosis?...................... 32

Treating Cognitive Impairment in Multiple Sclerosis .................................... 32

Medications to Reduce Cognitive Impairments ............................................. 32

11. Effects of Multiple Sclerosis....................................................... 33

The Invisible Symptom Factor ............................................................................. 33

Specific Effects of Multiple Sclerosis.................................................................. 33

12. Risk Factors for Multiple Sclerosis............................................ 36

Genetic Susceptibility in MS ............................................................................ 36

Vitamin D and Sunlight ..................................................................................... 36

Smoking and MS.................................................................................................... 37

Viral Triggers and MS ....................................................................................... 37

13. Genetic Factors for Multiple Sclerosis ...................................... 38

14. Nutritional Factors and Multiple Sclerosis................................ 39

15. Multiple Sclerosis and Your Emotions ...................................... 41

Common Emotional Reactions ............................................................................ 41

16. Stress and Multiple Sclerosis..................................................... 43

How Can I Reduce Stress? ................................................................................... 43

17. Depression and Multiple Sclerosis ............................................ 45

18. Multiple Sclerosis and the Self................................................... 46

19. Multiple Sclerosis and Pregnancy ............................................. 47

20. Multiple Sclerosis Fatigue .......................................................... 49

Mental Fatigue........................................................................................................ 49

Physical Fatigue .................................................................................................... 49

Managing Multiple Sclerosis Fatigue .................................................................. 50

21. Children and Multiple Sclerosis ................................................. 51

22. When to Seek Medical Care........................................................ 53

MS Symptoms that Require Medical Care .......................................................... 53

23. Diagnosis of Multiple Sclerosis ................................................. 56

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24. Factors for Progression of Multiple Sclerosis .......................... 59

25. Prognosis of Multiple Sclerosis ................................................. 61

26. Treatment and Medications for Multiple Sclerosis ................... 63

Available Medications and Treatments for MS ............................... 64

Steroids .................................................................................................................. 65

Medications to Reduce Stiffness ......................................................................... 66

Medications to Reduce Neuropathic Pain........................................................... 67

Medications to Cure Bladder problems .............................................................. 67

Medications to Combat Fatigue ........................................................................... 67

Medications for Treating More Chronic and Progressive Forms of MS .......... 67

Precautions ............................................................................................................ 68

27. Multiple Sclerosis: Alternative and Complementary Therapies

............................................................................................................ 70

Alternative Therapies for MS................................................................................ 70

Complementary Therapy ...................................................................................... 71

Some Options of Complementary Therapy for MS ........................................ 71

28. Acupuncture and Multiple Sclerosis.......................................... 74

How It Works...................................................................................................... 74

Studies and Surveys on MS ................................................................................. 74

29. Herbs for Multiple Sclerosis ....................................................... 76

Herbs Used to Treat MS Symptoms .................................................................... 76

30. Vitamins and Minerals for Multiple Sclerosis ........................... 79

31. Dietary Therapy for Multiple Sclerosis ...................................... 81

Suitable Diets for MS Patients.............................................................................. 81

Foods to Avoid ...................................................................................................... 82

32. Yoga for Multiple Sclerosis ........................................................ 83

Precautions ............................................................................................................ 84

33. Prevention for Multiple Sclerosis............................................... 85

Simple Control Measures ..................................................................................... 85

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34. Coping Skills for Multiple Sclerosis........................................... 87

Coping at an Individual Level............................................................................... 87

Coping with Emotional Trauma ....................................................................... 88

Coping Socially.................................................................................................. 88

35. Self-Care for Multiple Sclerosis ................................................. 90

Some Self-Care Tips.............................................................................................. 90

36. Professional Help for Multiple Sclerosis ................................... 92

37. 20 Tips to Help Deal with Multiple Sclerosis............................. 94

38. Multiple Sclerosis – Frequently Asked Questions.................... 97

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“Living with Multiple Sclerosis” by Piet Mesmer

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Please Read This First!

Terms of Use

This Electronic book is Copyright © 2007. All rights reserved. No

part of this book may be reproduced, stored in a retrieval system,

or transmitted by any means; electronic, mechanical, photocopying,

recording, or otherwise, without written permission from the

copyright holder(s).

You do not have any right to distribute any part of this ebook in any

way at all. Members of eBookwholesaler are the sole distributors

and must abide by all the terms at

http://www.ebookwholesaler.net/terms.php

Disclaimer

The advice contained in this material might not be suitable for

everyone. The information is only a broad overview by a lay person

about an important subject.

The author obtained the information from sources believed to be

reliable and from his own personal experience, but he neither

implies nor intends any guarantee of accuracy.

Research is changing theories and practices in this area constantly.

The author, publisher and distributors never give legal, accounting,

medical or any other type of professional advice. The reader must

always seek those services from competent professionals that can

review their own particular circumstances.

Copyright © 2006 All rights reserved

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“Living with Multiple Sclerosis” by Piet Mesmer

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The author, publisher and distributors particularly disclaim any

liability, loss, or risk taken by individuals who directly or indirectly

act on the information contained herein.

All readers must accept all responsibility for their use of this

material. Always consult your own medical practitioner about

all matters related to your health, exercise and treatments

because they can correlate their knowledge and advice to

your individual personal circumstances

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“Living with Multiple Sclerosis” by Piet Mesmer

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About the Author

Piet Mesmer has friends and a close relative that are living with

Multiple Sclerosis.

He wanted to learn about the condition because he heard so many

conflicting theories and rumors. Few people were willing to discuss it

and Piet felt that a guide to the subject could be helpful to others

like him that dealt with people who had the disease and their

families.

He hopes that many people will be able to use this layman’s guide

as a starting point in their own search for knowledge, and to

counter some of the “old wives’ tales” that circulate, discourage or

frighten people whose lives are touched by Multiple Sclerosis.

Piet emphasizes that on-going research is bringing new information

and hope into this area. People should always consult their own

Doctors and other medical professionals about their condition and

the best ways to manage and treat it.

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Part-I: Introduction

1. Multiple Sclerosis – An Overview

Multiple sclerosis is a persistent and debilitating disease affecting

the central nervous system (your brain, nerve cells and spinal cord).

This inflammatory disease affects the patient’s mobility and can

cause severe disability.

Some doctors and researchers believe that this is an autoimmune

disease. That is where your immune system tries to defend against

the normal activities of other parts of your body - your immune

system attacks you.

The nervous system consists of neurons, brain, nerve cells and the

spinal cord. They work together to carry information between the

brain and other parts of your body.

Multiple sclerosis destroys the Myelin layer (a protective fatty layer

around the neurons that carry those electrical signals). This disrupts

the vital transfer of electrical signals across the spinal cord and

brain. This scars the myelin sheaths. These scars prevent easy

transmission of the signals. The intensity of the disease relates to

the extent of the scarring and the resultant impact on the rate and

quality of the transfer of the signals.

Incidence

There are around two and half million people in the world with

multiple sclerosis. Around 350,000 people in the U.S.A. suffer from

this disease. The disease most often starts between the ages of

twenty and forty. Sometimes, it occurs a bit later.

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It affects more women than men.

Another striking fact is that people living in the northern latitudes

such as parts of Northern Europe and the Northern United States

report higher incidence of the disease.

There are possibly genetic factors at work, too. Children whose

parents or siblings have multiple sclerosis, have a greater chance of

getting the disease.

The cause might be a virus that triggers a destructive reaction from

your immune system.

Types and Symptoms of Multiple Sclerosis

The effects of Multiple Sclerosis vary and are grouped according to;

• the severity of the symptoms,

• the frequency of attacks,

• the level of damage, and

• the ability of your central nervous system to recover.

Accordingly, multiple sclerosis (MS) could be:

• Relapsing-remitting MS,

• Relapsing progressive MS,

• Secondary progressive MS, or

• Primary progressive MS.

Common symptoms of the disease may include;

• partial loss of vision or total loss of vision in one eye,

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• double vision,

• general weakness,

• change in sensation of hands, legs, and face,

• unsteady walking with acute balance problems.

These symptoms may not show to a great degree in some cases.

Also, they may come and go.

Many people only notice mild effects in the early stages which they

either ignore or do not ask their doctor about.

Sometimes, trauma, infection, or severe physical exhaustion could

trigger the symptoms of MS.

Some patients are affected by the symptoms of multiple sclerosis

from time to time, but are perfectly normal between attacks, with

perhaps a few neurological problems that persist permanently.

The exact cause of multiple sclerosis is still unknown. Treatments

can slow down the appearance of new symptoms but there is no

permanent cure for the disease right now.

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Part-II: Understanding Multiple Sclerosis

2. What is Multiple Sclerosis?

Multiple Sclerosis is a complex, chronic, inflammatory disease of

the central nervous system. It is a degenerative disease that

gradually destroys the myelin sheath and thus causes weakness to

the muscles, loss of speech and visual coordination.

The myelin sheath is a fatty layer that surrounds and protects the

neurons which carry messages (electronic signals) between the

brain and other parts of the body. The role of the myelin is

important.

The damage to the myelin causes symptoms of different intensity in

sufferers. Multiple sclerosis is divided into two groups according to

this intensity and frequency. They are the relapsing-remitting type

and the chronic-progressive type.

Chronic-progressive Multiple sclerosis is again divided into

primary-progressive, secondary-progressive and progressive-

relapsing types.

Repeated attacks may occur along the brain and the spinal cord

area, with symptoms lasting from a few days to months. It makes

the body work erratically.

Your natural antibodies, white blood cells, work against the myelin

sheath. There is inflammation and injury to the sheath, which

ultimately causes injury to the nerves it protects. This results in the

scarring of multiple areas, which gives multiple sclerosis its name.

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This scarring slows and blocks the nerve signals, which are essential

to control muscle coordination, strength, vision, and sensation.

Multiple sclerosis is likely to affect the young adult between the

ages of 20 to 40. It affects twice as many women as men.

The cause of the disease may be a defect in the immune system,

either of genetic or viral origin. Geographical studies indicate a

greater prevalence of this disease in northern Europe, northern

United States, southern Australia, and New Zealand.

At present, the actual cause, or the trigger for this disease is

unknown. This makes effective treatment very difficult. However,

the fact that it is not a life threatening disease brings some relief.

With the help of current treatments, a patient’s multiple sclerosis

can be controlled to a fair degree so that many of them can lead an

active and normal life.

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3. The Immune System and Multiple Sclerosis

Immune System

There are about 60 trillion cells in the human body. This is an

excellent environment for microbes to grow in and live happily. Most

microbes do not cause any trouble for us. In fact, some are very

beneficial and help us digest our food.

However, some microbes (known as the pathogens) can cause our

body much trouble and even prove fatal. The immune system fights

these harmful microbes.

Our immune system has two parts: the innate, or the natural

system, and the acquired, or the specific, immune system. The cells

from both these groups are equally involved in the damage caused

by multiple sclerosis.

Relation between the Immune System and Multiple Sclerosis

When a person suffers from multiple sclerosis, the body cells invade

their own tissues, treating them like their enemy in a war.

There is some evidence that indicates multiple sclerosis is an

autoimmune disease. These are disorders of the immune system.

The immune system is responsible for identifying the harmful

invaders of the body and destroying them. A recent study focused

on how the immune system reacts in the people with multiple

sclerosis.

The study indicated that multiple sclerosis causes abnormalities in

the immune system. The first evidence is the presence of white

blood cells that react with the protein found in the myelin sheath.

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Multiple sclerosis develops in individuals through viral or bacterial

infection.

The second indicator is the presence of T-cells in the spinal fluid of

people that have multiple sclerosis. When spinal fluids were further

analyzed, IgG – protein was found in high quantity. Then

electrophoresis showed oligoclonal banding, further supporting the

autoimmune theory.

There are still are more questions than answers. At present there

are three factors that different researchers believe are responsible

for the disease; environmental factors, hereditary factors and a

virus. Each of them have found significant acceptance amongst

researchers.

What causes multiple sclerosis in an individual is still debatable, but

the autoimmune theory comes closest to matching the results of the

researches made to date.

Researchers believe that a pathogen that triggers the T-cells

response is still not identified despite all the searches made.

No particular multiple sclerosis antigen has been found.

The other existing theory is nothing but a compilation of all the

other facts about multiple sclerosis.

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4. How Serious Is Multiple Sclerosis?

Multiple sclerosis is a disease that may shorten a person’s life span

by six to seven years. Half the people that suffer from multiple

sclerosis die because of its effects. Suicidal tendencies are also very

high among people suffering from multiple sclerosis.

The severity is very unpredictable and the symptoms vary from

person to person. This disease affects the central nervous system

and the damage done to the nerves is extensive.

The major problems of multiple sclerosis are -

Fatigue: Fatigue is one of the most common symptoms of multiple

sclerosis, affecting 75% to 90% of the patients. More than half of

them experience fatigue on a daily basis. Poor control over the

condition and the resultant acute sensitivity to physical sensation

may be the main cause of stress with multiple sclerosis.

Loss of mobility and spasticity (stiffened muscles): Each

person with multiple sclerosis loses control over their muscles and

suffer spasticity where their muscles resist stretching. Spasticity is

one of the main symptoms of multiple sclerosis. Mild spasticity may

improve muscle toning in the legs, which supports the patients’ leg

while walking.

Pain: About two-thirds of people suffering from multiple sclerosis

experience pain at some point of time. Multiple sclerosis may cause

acute or chronic pain syndromes; cramps, spasms, optic neuritis

pain, pain on the joints and the feeling of itching and burning.

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Bowel, urinary and sexual dysfunction: Bowel dysfunction, like

constipation, occurs in people with multiple sclerosis. This

dysfunction may be due to medications. Two-thirds of the people

suffering from multiple sclerosis also complain of urinary problems

due to bladder dysfunction.

Another problem that occurs is sexual dysfunction. Both male and

female patients may have problems in achieving sexual satisfaction.

Cognitive impairment: Most people with multiple sclerosis have

trouble concentrating and focusing. The severity increases as the

degree of damage done to brain tissue increases.

Depression: Around 40% to 60% of people suffering from multiple

sclerosis suffer from depression. They sometimes commit suicide

while depressed.

Osteoporosis: Osteoporosis (loss of bone density) occurs due to

immobility and some medications. Factures caused by falls in people

with multiple sclerosis tend to be more serious than with people

suffering from many other diseases.

Lung Problems: With the weakening of the muscles, there comes

difficulty in coughing. The result of this may be a higher chance of

getting pneumonia and other lung complications.

The Effects at a Glance:

1. Multiple sclerosis destroys the myelin sheath, the layer that

protects the nerve cells.

2. It affects many body functions, including speech, memory,

vision and body movements.

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3. This disease mostly affects women.

4. Multiple sclerosis currently affects 400,000 people in the US

and as many as 2.5 million worldwide.

5. It brings about dysfunction of body functions, like urinary,

sexual and bowel problems.

6. Many patients become seriously depressed with this disease

and some develop suicidal tendencies.

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5. Who Gets Multiple Sclerosis?

Age: Multiple sclerosis occurs mostly in people between the ages of

20 and 40. The average age for this disease is 30 and the most

patients symptoms appear in their mid-twenties. However, this

disease can also occur, rarely, in children and older people over 60

years.

Gender: Women are twice as likely to be affected by this disease as

men are. Statistics also show a continuing rise among women. But,

men are often more seriously affected by this disease than women.

Ethnicity: Multiple sclerosis is found in most countries. It is more

common in Caucasian people living in Northern Europe; especially

Scotland. This disease is rare in Asian and African people.

Geography: The risk of multiple sclerosis varies with different

regions of the world. The disease is more common in the temperate

regions than the tropics. It is more prevalent in Northern and

central Europe except the Scandinavia. Low risk areas are Africa,

Asia, the Caribbean, Mexico, and even Northern South America. It is

not clear whether this mostly due to environmental reasons or

genetic reasons.

Family History: Multiple sclerosis may also occur due to the family

history of the disease. However, there is only a low chance (2 to

4%) of inheriting all the genetic factors of the disease. When

siblings have this disease, the severity and occurrence of the

disease are likely to be about the same for each.

Cow’s Milk during early infancy: Mother’s milk contains all the

factors that help the baby’s body to control the immune responses.

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There is some possible indications found by research that children

fed with cow’s milk during infancy may have higher chances for

developing type 1 diabetes or multiple sclerosis. There are different

milk proteins in different cows’ milk, all cow’s milk are not same and

some proteins may lead to a higher risk than others.

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6. Types of Multiple Sclerosis

1. Relapsing, or Remitting, Multiple Sclerosis: The main

characteristic of this type of Multiple Sclerosis is relapses; during

which some new symptoms may appear while the previous ones

may be less or recur to the same level as before.

Remission usually follows the period of relapse. During this phase

the patient may partly recover from the deficiencies that were

caused by the relapse.

Relapsing or remitting sclerosis is diagnosed when the patient is at

the age of twenty or thirty. The relapse may start slowly or happen

quickly. It may last for days or even months. Women are affected

twice as much than men are with this type of multiple sclerosis.

After 10 years, 50% of the people with relapsing/remitting multiple

sclerosis develop secondary progressive.

2. Secondary, Progressive Multiple Sclerosis: This form of

sclerosis progresses steadily with gradual deterioration of the nerve

function. After years of this disease, the person will gradually enter

the secondary phase.

In the second stage, the disease worsens between relapses. At the

beginning of the secondary progressive multiple sclerosis, the

patient may suffer from few relapses. This gradually becomes a

steady progression.

People with secondary progressive may experience bad and good

times that last days or even weeks; but there is almost no chance of

complete recovery.

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3. Progressive, Relapsing Multiple Sclerosis: Progressive

relapsing multiple sclerosis shows steady progression of the level of

disability from the first time that the symptoms begin to appear.

This form of multiple sclerosis progresses from the very beginning.

There may be significant recovery after a relapse but overall the

symptoms continue to worsen significantly.

4. Primary, Progressive Multiple Sclerosis: The characteristic of

this type of multiple sclerosis is the gradual progression of the

disease. This phase occurs in about 10% of people with multiple

sclerosis. When the person had primary progressive multiple

sclerosis, there are high chances of a body disability in the person.

The person does not suffer from acute attacks and this makes the

initial diagnosis more difficult. Primary Progressive multiple sclerosis

often passes to the brain but rarely does damage to the brain areas.

There is less chance for a person with primary progressive multiple

sclerosis to develop cognitive impairment.

Other Common Terms for Multiple Sclerosis:

1. Benign multiple sclerosis: This type describes the kind of

multiple sclerosis that a person may have for years, but it has not

caused any disability.

2. Malignant multiple sclerosis: This is the term used for the

form of multiple sclerosis where the disease rapidly progresses and

brings severe disability to the body. This is a rare type of multiple

sclerosis.

3. Chronic Progressive multiple sclerosis: Primary Progressive

and Secondary Progressive together are teamed Chronic

Progressive.

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4. Transitional/Progressive multiple sclerosis: This phrase

refers to multiple sclerosis but it is hardly used. This type of multiple

sclerosis progresses steadily course after a quiet period.

5. Devic's Disease: Devic’s Disease is a condition that is related to

multiple sclerosis. This disease attacks the optic nerve in both eyes

and this is followed by the acute inflammation of the spinal cord.

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7. Signs and Symptoms of Multiple Sclerosis

Multiple sclerosis has a variety of symptoms and its course varies

from person to person. Even while there are no noticeable

symptoms, some damage to the central nervous system may be

occurring.

Therefore, patients must stick to the prescribed treatment unless

specifically advised otherwise by their medical practitioner.

The signs and symptoms of common multiple sclerosis are:

1. Optic neuritis: This symptom of multiple sclerosis is

inflammation of the optic nerve. With time, you start developing

blurred vision. You may feel the pain behind your eye at times, but

it may lessen when you turn your eye.

2. Loss of muscle strength in arms and legs: The nervous

system controls the motor function that powers our movement.

People with multiple sclerosis lose the muscular strength of their

arms and legs as the disease progresses. Slowly, they lose control

of their fingers.

This may lead to paralysis of the leg or arm.

3. Changes in the sense of touch: The disease damages the

fibers that provide the fingers and other parts of the body with the

sensation of hot or cold. Then, the body may feel a burning

sensation or cold even though the environment is not causing it.

4. Pain: You may often feel a burning pain in your legs and arms.

Multiple sclerosis may damage the nerves of your face and lead to a

painful condition known as ‘trigeminal neuralgia.’

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5. Bladder and bowel problems: People with multiple sclerosis

lose the control over the urge to urinate and their bowel

movements.

6. A dysfunction in sex: Multiple sclerosis may lead to many

sexual dysfunctions in men and women. It may be difficult for them

to satisfy their sexual needs.

7. Balance and coordination problems: Multiple Sclerosis

damages the brain which may result in difficulties with balance and

coordination problems.

You may have problems in grasping an object, writing and even

keeping your hand steady. You may lose your balance while walking

and react as though intoxicated. These problems may be temporary,

only appearing during a relapse, or may be a permanent result of

the disease.

8. Cognitive impairment: During the course of the illness, you

may notice some loss of memory or thinking speed. You may have

difficulties when focusing and concentrating. In some people, these

impairments set in very early but it may come later on for other

people.

9. Mood Swings: There may be phases of depression, due to the